Neuromuscular Electrical Stimulation of Upper Limbs in Patients With Cerebral Palsy: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Objective The aim of the study is to assess the effects of neuromuscular electrical stimulation on the upper limbs of patients with cerebral palsy. Design We searched PubMed, Cochrane, Embase, and Scopus databases for randomized controlled trials examining the effects of neuromuscular electrical stimulation on the upper limbs of children with cerebral palsy. Results Eight randomized controlled trials (N = 294) were included in the meta-analysis. Compared with traditional physical therapy, sensorimotor training and task-oriented training, constraint-induced movement therapy, dynamic bracing, and conventional robot-assisted therapy, neuromuscular electrical stimulation in combination with these therapies resulted in significantly greater functional scale scores (standardized mean difference = 0.80; 95% confidence interval = 0.54 to 1.06), muscle strength of upper limbs (standardized mean difference = 0.57; 95% confidence interval = 0.25 to 0.88), and spasticity of upper limbs (relative risk = 2.53; 95% confidence interval = 1.46 to 4.39; standardized mean difference = −0.18; 95% confidence interval = −0.29 to −0.06) but did not improve the wrist range of motion (standardized mean difference = 0.43; 95% confidence interval = −0.04 to 0.91). In addition, the effect of neuromuscular electrical stimulation on functional scale scores remained after 3-mo follow-up (standardized mean difference = 0.68; 95% confidence interval = 0.16 to 1.2). Conclusions Neuromuscular electrical stimulation effectively improved hand function, muscle strength, and spasticity in patients with cerebral palsy.